History of syphilis in women living with AIDS and associated risk factors in São Paulo, Brazil

Abstract

Objective: to describe the epidemiological profile, risk behaviors, frequency of prior history of syphilis in women living with AIDS and to investigate associated factors. Methods: a cross-sectional study conducted with women living with HIV attending at Reference Center for AIDS in São Paulo. Demographic, behavioral, and clinical data were analyzed based on medical records. Results: a total of 598 women were included in the study and the prevalence of previous syphilis was 6.2% (95% CI 4,3-8,1). Seventy-three percent of women were less than 40 years of age when diagnosed with AIDS and 49.6% had more than eight years of formal education. 67.2% were white and 65.9% were not married or living with a partner, 53.2% reported that their first sexual intercourse aged more than 15 years, 56.5% reported having only one partner in the last year and 13% reported drug use. Regarding laboratory data, 83.8% had CD4+ <500 cells/ mm 3 upon diagnosis of AIDS. Previous syphilis was associated with the use of crack cocaine [AOR = 6.8 (95% CI 1.7 -27.5)], >1 sexual partner in the last year [AOR = 6.6 (95% CI 1.2 -37.1)], CD4 + <500 cells/mm 3 [AOR = 3.8 (women 1.1 -13.6)], HIV diagnosis > 8 years [AOR = 2.4 (95% CI 1.0 -5.8)]. Conclusion: a high prevalence of previous syphilis was found in the population studied, and crack use was identified among the main associated risk factors. Interventions to reduce the risk of sexual transmission of HIV and syphilis must be strengthened, with the implementation of control actions, screening strategies, early diagnosis and treatment, preventing complications, reducing morbidity and improving sexual and reproductive health.

Prevalence and factors associated with syphilis in a Reference Center

“…In the context of vulnerability, investigators consider some populations as more likely to acquire syphilis: individuals living in seclusion, homeless people, drug users, men who have sex with men (MSM), those co-infected with human immunodeficiency virus (HIV), and pregnant women [8][9][10][11][12][13][14] .…”

Novas problemáticas sociais: o uso do crack em mulheres e a perspectiva de gênero

“…Estudos sobre mulheres usuárias de crack apontam para o início do uso de drogas ainda na adolescência (Marangoni & Oliveira, 2013), com uso atual de outras drogas concomitantemente (Costa, Soibelman, Zanchet, Costa, & Salgado, 2011) a comorbidades psiquiátricas (Lima, Macedo, Braga, Lemos, & Silva Júnior, 2011) e a níveis séricos elevados de alumínio (Pechansky, Kessler, Von Diemen, Bumaguin, Surratt, & Inciardi, 2007). A prostituição é apontada pelas mulheres como uma forma de obtenção do crack (Pedroso, Kessler, & Pechansky, 2013), acarretando doenças sexualmente transmissíveis, HIV e AIDS (Correa, Matumoto, & Lonardi, 2008;Malta, et al, 2008;Nappo, Sanchez, & Oliveira, 2011;Pinto, Tancredi, Buchalla, & Miranda, 2014;Von Diemen, De Boni, Kessler, Benzano, & Pechansky, 2010).…”

Women users of crack: systematic review of Brazilian literature

“…Regarding the sociodemographic data found in the analyzed studies, the referred education background was less than eight years of formal education 15,16 and in most part of the searches women entitle themselves as single. As explained in a study 17 , the women users of crack have as a characteristic being consumers of licit and illicit drugs before 15 to 27 years old.…”